CAJ | 학술논문

目的：比较病毒灭活血浆与白蛋白复方氯化钠注射液（林格液）进行血浆置换（PE）治疗重症系统性红斑狼疮（SLE）的临床疗效。方法选取重症 SLE 患者75例，按数字表法将患者随机分为病毒灭活血浆组（A 组）37例和白蛋白加林格液代血浆组（B 组）38例，观察两组 PE 前后免疫球蛋白（IgG、IgA、IgM）、红细胞沉降率（ESR）、补体（C3）、CRP、血尿素氮（BUN）、血清肌酐（Cr）等指标的变化，比较两组系统性红斑狼疮疾病活动性指数（SLEDAI）评分系统积分变化、不良反应发生率及临床疗效。结果A 组患者行 PE 治疗后，实验室指标除 IgM（t ＝0．509，P ＝0．612）外，其余指标均明显下降，差异均有统计学意义（t ＝29．447、7.186、56．447、41.867、12．841，92．675、92．980，均 P ＜0．01）；B 组患者 IgM、IgA、CRP、C3与置换前差异均无统计学意义（t ＝0．565、1．165、0．902，均 P ＞0．05），IgG、ESR、BUN、CREA 与置换前差异有统计学意义（t ＝28.999、1．949、40.634、40．634、104．918，均 P ＜0．01）。A 组总有效率为91．9％、平均临床 SLEDAI 积分为（9.4±1．2）分，B 组总有效率为77．3％、临床 SLEDAI 积分为（13．8±1．1）分，两组差异均有统计学意义（χ2＝8．831，t ＝15.560，均 P ＜0．01）。A 组不良反应率率为15．3％，B 组为16．2％，两组差异无统计学意义（χ2＝0．509，P ＞0．05）。结论用病毒灭活血浆置换液治疗重型 SLE 临床疗效优于白蛋白林格液。
목적：비교병독멸활혈장여백단백복방록화납주사액（림격액）진행혈장치환（PE）치료중증계통성홍반랑창（SLE）적림상료효。방법선취중증 SLE 환자75례，안수자표법장환자수궤분위병독멸활혈장조（A 조）37례화백단백가림격액대혈장조（B 조）38례，관찰량조 PE 전후면역구단백（IgG、IgA、IgM）、홍세포침강솔（ESR）、보체（C3）、CRP、혈뇨소담（BUN）、혈청기항（Cr）등지표적변화，비교량조계통성홍반랑창질병활동성지수（SLEDAI）평분계통적분변화、불량반응발생솔급림상료효。결과A 조환자행 PE 치료후，실험실지표제 IgM（t ＝0．509，P ＝0．612）외，기여지표균명현하강，차이균유통계학의의（t ＝29．447、7.186、56．447、41.867、12．841，92．675、92．980，균 P ＜0．01）；B 조환자 IgM、IgA、CRP、C3여치환전차이균무통계학의의（t ＝0．565、1．165、0．902，균 P ＞0．05），IgG、ESR、BUN、CREA 여치환전차이유통계학의의（t ＝28.999、1．949、40.634、40．634、104．918，균 P ＜0．01）。A 조총유효솔위91．9％、평균림상 SLEDAI 적분위（9.4±1．2）분，B 조총유효솔위77．3％、림상 SLEDAI 적분위（13．8±1．1）분，량조차이균유통계학의의（χ2＝8．831，t ＝15.560，균 P ＜0．01）。A 조불량반응솔솔위15．3％，B 조위16．2％，량조차이무통계학의의（χ2＝0．509，P ＞0．05）。결론용병독멸활혈장치환액치료중형 SLE 림상료효우우백단백림격액。
Objective To compare the clinical curative effect of virus inactivating activity of plasma and albumin compound sodium chloride injection in liquid plasma exchange(PE)for treatment of severe systemic lupus erythematosus(SLE).Methods A total of 75 cases of severe SLE patients were randomized according to the number table method patients for virus inactivation of plasma group A(37 cases)and liquid albumin plasma group B (38 cases). The changes of immunoglobulin protein(IgG,IgA,IgM),ESR,complement C3,C -reactive protein(CRP),blood urea nitrogen(BUN)and serum creatinine(CR)index in the two groups were observed before and after PE.Clinical SLE-DAI(systemic lupus erythematosus disease activity index)score changes,adverse reactions occurred rate and clinical efficacy of two groups were compared.Results After treatment of group A was treated with PE,laboratory indicators except IgM(t =0.509,P =0.612),other indexes were significantly decreased,differences were statistically significant (t =29.447,186,56.447,41.867,12.841,92.675,92.980,all P <0.01).In group B,the IgM,IgA,CRP,C3 and preoperative showed no statistical significance(t =0.565,1.165,0.902,all P >0.05),while IgG and ESR,bun,crea and replacement of the differences have statistical significance(t value were 28.999,194.9,40.634,40.634104.918, P value <0.01 ).Ttotal efficiency of group A was 91.9%,the average clinical SLEDAI score was (9.4 ± 1.2)points,total efficiency of group B was 77.3%,clinical SLEDAI score was (13.8 ±1.1 )points and the difference between the two groups were statistically significant(χ2 =8.831,t =15.560,P <0.01).In group A,the adverse reaction rate was 15.3%,that of group B was 16.2%,there was no significant difference between the two groups(χ2 =0.509,P >0.05).Conclusion The clinical curative effect of virus inactivation of plasma replacement solution in treatment of severe SLE is better than that of albumin by Ringer's solution.